Epicardial Lipomatosis as a Cause of Constrictive Pericarditis.

Epicardial lipomatosis is a rare cause of constrictive pericarditis. There is a paucity of literature on the condition, and it is possible that it may be missed in contemporary clinical practice. Herein, we report two patients with epicardial lipomatosis who presented with traditional cardiovascular risk factors. After an initial suspicion of pericardial effusion, both patients underwent multimodality imaging with transthoracic echocardiography, computed tomography, and cardiac magnetic resonance imaging, which demonstrated diffuse epicardial fat. Conservative management was pursued in both cases with optimization of heart failure therapy and the dialysis strategy, resulting in clinical improvement.